Implementation of an Evidence-based Suicide Prevention Program for a Primary Care Network of Clinics in Rural Appalachia

Background of the Clinical Issue: The US has the highest rate of suicide of the ten wealthiest nations in the world; one person dies every 40 seconds from suicide. Despite current healthcare efforts, the number of suicides continues to rise and is at an all-time high. Nearly half of the individuals who commit suicide have seen a primary care provider (PCP) within one month of suicide completion. This positions PCPs at the forefront in the identification and prevention of patient suicide. 

Study Purposes: The purpose of this project is to implement an evidence-based (EB) suicide prevention (SP) resource guide with a suicide-prevention point-of-care (SP POC) contact for PCPs and nurses in rural Appalachia to enhance assessment and referral process.

Methods to Include the Intervention and Implementation: The EB project will be implemented in four nurse-led clinics in rural Appalachia.  In phase one, the providers, nurses, and SP POC contacts will receive two educational lectures derived from The SP Toolkit for Primary Care Practices as well as a SP resource guide containing: the toolkit, SP algorithm (protocol), and Suicide Safe phone application.  Post-education, participants will complete REDCap surveys reporting the use of the toolkit contents, resource guide contents, generation of referrals, and satisfaction with the project.

Data Collection and Evaluation: Participant knowledge will be measured using a pretest/posttest survey.  The principal investigators will analyze the surveys collected, develop referral outreach letters, attend monthly staff meetings to answer questions and make recommendations for improvements as needed, and develop policies and procedures based on feedback given.

Expected Evidence Contribution and Significance: Implementation of SP resources with a protocol reduces health care provider burden and promotes integrated care for patients, leading to earlier identification of suicidal ideation, referral, and treatment.